Provider Demographics
NPI:1326102153
Name:KRITCHMAN, KERRIN (MA, LCMHC)
Entity Type:Individual
Prefix:
First Name:KERRIN
Middle Name:
Last Name:KRITCHMAN
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 GOVERNMENT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9382
Mailing Address - Country:US
Mailing Address - Phone:802-355-8989
Mailing Address - Fax:
Practice Address - Street 1:98 GOVERNMENT HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:VT
Practice Address - Zip Code:05602-9382
Practice Address - Country:US
Practice Address - Phone:802-355-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009404Medicaid